Immunotherapy in Esophagogastric Cancer: Treatment Landscape, Challenges, and New Directions

Background: Cancers of the upper gastrointestinal tract represent a lethal disease entity comprising the esophagus, gastroesophageal junction, and stomach. The backbone of therapy in esophagogastric cancers has predominantly been chemotherapy-based. However, over the last decade, with the debut of immune checkpoint inhibitors, sophisticated molecular testing, and a more comprehensive understanding of the tumor microenvironment, immunotherapy has been incorporated into the treatment of localized and advanced esophagogastric cancers with promising results. Purpose: This study aimed to review the unique tumor microenvironment and role of immunotherapy in esophagogastric cancers. Methods: We conducted a systematic review of clinical and translational research for immunotherapy in esophagogastric cancers. Results: This article will explore the unique tumor microenvironment in gastroesophageal cancers, the role of immunotherapy in localized and advanced disease, challenges in management, and new therapeutic approaches in clinical trials. Conclusion: With further exploration into targeted therapy and immunotherapy, we anticipate the emergence of novel treatments that will improve survival and quality of life in patients with esophagogastric cancers.